| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $2,381 | $2,408 | $2,435 |
| Discectomy lumbar single level CPT 63030 • Orthopedics | $2,387 | $2,759 | $3,131 |
| Laminectomy lumbar single level CPT 63047 • Orthopedics | $2,708 | $3,128 | $3,549 |
| Carpal tunnel release CPT 64721 • Orthopedics | $538 | $538 | $538 |
| Sacroiliac joint injection CPT 27096 • Pain Management | $196 | $322 | $396 |
| Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management | $346 | $483 | $619 |
| Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management | $92 | $272 | $452 |
| Epidural injection lumbar or sacral with imaging CPT 62323 • Pain Management | $310 | $575 | $840 |
| Spinal cord stimulator electrode implantation CPT 63650 • Pain Management | $485 | $4,018 | $7,550 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $105 | $147 | $189 |
| Plantar common digital nerve injection CPT 64455 • Pain Management | $38 | $38 | $38 |
| Epidural injection lumbar or sacral transforaminal CPT 64483 • Pain Management | $130 | $319 | $509 |
| Epidural injection lumbar each additional level CPT 64484 • Pain Management | $121 | $127 | $133 |
| Facet joint injection lumbar first level CPT 64493 • Pain Management | $401 | $412 | $423 |
| Facet joint injection lumbar second level CPT 64494 • Pain Management | $131 | $165 | $199 |
| Chemodenervation of muscle migraine CPT 64615 • Pain Management | $302 | $302 | $302 |
| Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management | $529 | $830 | $981 |
| Facet joint nerve destruction lumbar each additional CPT 64636 • Pain Management | $139 | $279 | $408 |
| Cytopathology concentration technique CPT 88108 • Pathology | $35 | $58 | $81 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $44 | $64 | $84 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $16 | $22 | $28 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $9 | $15 | $21 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $18 | $27 | $35 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $14 | $21 | $28 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $20 | $31 | $43 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $18 | $29 | $40 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $7 | $30 | $52 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $23 | $27 | $30 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $105 | $372 | $649 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $89 | $319 | $550 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $58 | $100 | $142 |
| Special stain group II CPT 88313 • Pathology | $35 | $68 | $102 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $27 | $39 | $51 |
| Frozen section pathology each additional CPT 88332 • Pathology | $19 | $44 | $69 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $59 | $85 | $112 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $21 | $75 | $128 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $26 | $90 | $153 |
| Microdissection manual CPT 88381 • Pathology | $133 | $198 | $263 |
| Hot or cold packs application CPT 97010 • Physical Therapy | $5 | $10 | $14 |
| Electrical stimulation unattended CPT 97014 • Physical Therapy | $12 | $21 | $30 |
| Vasopneumatic device therapy CPT 97016 • Physical Therapy | $11 | $20 | $28 |
| Electrical stimulation attended each 15 minutes CPT 97032 • Physical Therapy | $13 | $24 | $35 |
| Ultrasound therapy each 15 minutes CPT 97035 • Physical Therapy | $14 | $24 | $34 |
| Therapeutic exercises each 15 minutes CPT 97110 • Physical Therapy | $26 | $48 | $71 |
| Neuromuscular reeducation each 15 minutes CPT 97112 • Physical Therapy | $33 | $57 | $82 |
| Gait training each 15 minutes CPT 97116 • Physical Therapy | $28 | $50 | $71 |
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $26 | $46 | $65 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $17 | $30 | $42 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $97 | $169 | $241 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $97 | $169 | $241 |